In my practice in the past six months, no less than five youths have reported psychotic symptoms that were attributed to, or exacerbated by, electronic screen devices.

As per my protocol, I always get a "screen-time" history:

video games (including handheld)

computer/internet use, especially using laptops and ipad

cell phone/smartphone use (talking, texting, streaming, and internet

television (especially cartoons/animated, 3-D, or watching on a laptop)

Not surprisingly, all five of these patients, ranging from 15-22 years old, were “plugged in” for six or more hours each day. Three were female and two male. After discussing electronic screens’ toxic influence on the brain, I recommended to each of these patients that they forego all interactive electronic media for at least four weeks.

The three females all decided to go “cold turkey ” and gave up their games, laptops, and phones. All three saw their symptoms resolve completely within a month. Of the two males, one cut down use significantly and his hallucinations disappeared; his paranoia remained but was less severe which in turn improved dysfunction. The other male turned out to be severely addicted to the internet and video games and flat out refused to change his habits at all. Needless to say the young man continues to suffer from psychotic symptoms.

Importantly, the therapeutic effects were achieved without using medication! This is a big deal, because medications used to treat psychotic symptoms are heavy duty, and have serious side effects--weight gain, hormone dysfunction, and movement disorders, which can be irreversible.

Psychosis is defined by abnormal thinking. This can involve thought content, such as hallucinations, delusions, or paranoia, or thought process (highly disorganized thinking, or feeling like thoughts are “blocked”). It is typically attributed to the severely mentally ill, like schizophrenics, but can also be seen in “normal” people under extreme stress. Children in particular are more likely to hallucinate when traumatized, sleep-deprived, or over-stimulated. Interactive electronic screen use cause or mimic all three of these states!

Take home point: Children, teens, and young adults who have unexplained hallucinations or delusions should have ALL electronic screendevices removed for at least 3 weeks, as part of the diagnostic work up. This includes cell phones, as texting, media viewing, and internet use can quickly rack up hours. Virtually all teens and many young adults do not yet have the impulse control to moderate their own usage, so parents should physically remove these devices. While this may seem extreme, drastic times cause for drastic measures. Psychosis–and treatment thereof–is serious and has long-lasting effects.

As psychiatric disorders in young people continue to explode, and evidence mounts about the toxic effects of electronin media on the developing brain, parents and clinicians would be prudent to remove this offending environmental trigger from the child’s life, as part of the diagnosis and as one “arm” of any mental health treatment plan.

When you start to feel conflicted about removing screens--they are so ingrained in our lives, after all--this is what I tell my patients and their parents: “You will never regret removing video games and computer use, but you may sorely regret letting them remain. “

“I know no one’s really there, but it’s still scary.” - that's not psychosis. Psychosis is the inability to differentiate between reality and fantasy. Anxiety disorders are characterised by having irrational thoughts the sufferer knows do not represent reality but is still scared of them. In fact, some are so scared they will go to lengths to stop their thoughts from coming true, even though they are completely clear that their behaviour is irrational - that's OCD. This man is describing anxiety.

As for hearing voices at night. Lots of people hear voices at night. It's called hypnagogia. If you hear voices and know the voices aren't real, you are suffering from hallucinations (caused by many things, including sleep deprivation, severe anxiety and physical disorders) but not psychosis (where you believe the voices are real).

With all due respect, you cannot tell me what this man is describing based on one sentence, although I'm sure he was feeling anxious when these symptoms occured.

Hypnagogic and hypnapompic hallucinations are hallucinations that occur when falling asleep or waking up, respectively, and can be normal. The brain is in a "twilight" state between awake and asleep. "At night" means simply that--at night. Obviously I screen for hypnagogic/pompic phenomena when determining what kind of hallucinations the patient is experiencing.

This particular young man experienced paranoia and thought he could see people standing outside his window. During the day, he knew the people weren't really there, but at night, he couldn't be certain.

People with trauma can hear voices and know they're not really there; that is, they have some reality testing intact. The same seems to be true when psychosis is from electronic screen media, and the intact reality testing should be a clue that the individual is not suffering from a more severe mental illness.

Semantics aside, I have seen many patients who were started on antipsychotics unnecessarily when they were really suffering from overstimulation from electronic media. This article is for both the general public and clinicians to be file this away in the back of their minds when a loved one or a patient someone "hears voices" or "sees things." It's simple enough to remove screens for a few weeks and see if the symptoms lessen or even resolve.

I apologise, then, but the way you wrote the article made it sound like his reality testing was intact ("I knew there was no one there"). I agree severe mental health disorders should not be diagnosed without looking for environmental reasons. There are some writers who seem irrationally opposed to computer technology who use words like psychosis as a scare tactic - but when you read their evidence it is full of holes. The misunderstanding over whether the boy really thought there was someone outside of his window just rang alarm bells with me, but it makes more sense now you have explained it.